Contract Type code value request for Encounters reporting (Post-adjudicated claims)
837 Professional and Dental - 2300/CN101, 2400/CN101
837 Institutional - 2300/CN101
Requesting the use of code value 'FR' (Firm Fixed Price) which is listed in the 837 Standard Workbook for data element CN101, but not in the X12 TR3. Otherwise, the creation of a new code value is needed.
The available values found in the X12 TR3 does not correspond to how majority of our providers are reimbursed. For many providers and outpatient hospital services, the reimbursement is on a fee-for-service fee schedule basis that is derived from relative value units and not based on DRG, per diems, flat rates or percentages.
Current CN101 Contract Type values per the X12 TR3:
02 Per Diem
03 Variable Per Diem